Citramon P pills, 20 pcs.

Composition

Active ingredients:

acetylsalicylic acid-240 mg,

paracetamol-180 mg,

caffeine monohydrate or caffeine (caffeine anhydrous) -30 mg.

Auxiliary substances:

cocoa – 14 mg,

citric acid – 5 mg,

potato starch – 63 mg,

low molecular weight povidone (polyvinylpyrrolidone low molecular weight medical) – 4 mg,

talc – 9 mg,

calcium stearate-5 mg.

Pharmacological action

of Acetylsalicylic acid has antipyretic and anti-inflammatory effect, reduces pain, especially caused by the inflammatory process, as well as moderately inhibits platelet aggregation and thrombus formation, improves microcirculation in inflammation.

Caffeine increases the reflex excitability of the spinal cord, excites the respiratory and vasomotor centers, expands the blood vessels of skeletal muscles, brain, heart, kidneys, reduces platelet aggregation; reduces drowsiness, fatigue. In this combination, caffeine in a small dose has almost no stimulating effect on the central nervous system, but it helps regulate the tone of brain vessels.

Paracetamol has analgesic, antipyretic and weak anti-inflammatory effects, which is associated with its effect on the center of thermoregulation in the hypothalamus and a weakly expressed ability to inhibit the synthesis of prostaglandins (Rd) in peripheral tissues.

Indications

Mild to moderate pain syndrome (of various origins): headache, migraine, toothache, neuralgia, myalgia, arthralgia, algodismenorrhea. Febrile syndrome: in acute respiratory diseases( ARI), influenza.

Contraindications

-Peptic ulcer of the stomach and duodenum in the acute phase;

– Gastrointestinal bleeding (including in the anamnesis);

–  Expressed disorders of liver function and/or kidney disease, and gout

, Hemorrhagic diathesis, hypocoagulation;

Surgical intervention, accompanied by profuse bleeding;

Pregnancy (I and III trimester), lactation;

– Deficiency of glucose-6-phosphate dehydrogenase;

– Glaucoma;

– Hypersensitivity to the drug, asthma induced by acetylsalicylic acid, salicylates and other nonsteroidal anti-inflammatory drugs;

– Children’s age (under 15 years – the risk of Reye’s syndrome in children with hyperthermia on a background of viral diseases);

– Increased irritability, sleep disorders;

Organic cardiovascular disease (including acute myocardial infarction, atherosclerosis);

–  Severe arterial hypertension

-Portal hypertension

-Avitaminosis K

-Hypoproteinemia

With caution

Mild to moderate renal insufficiency, hepatic insufficiency with increased transaminase levels, benign hyperbilirubinemia (including Gilbert’s syndrome, alcoholic liver damage), alcoholism, epilepsy and a tendency to convulsive seizures, old age, gout, arterial hypertension.

Side effects

There may be side effects characteristic of acetylsalicylic acid, paracetamol and caffeine: anorexia, nausea, vomiting, gastralgia, decreased platelet aggregation, erosive and ulcerative lesions of the gastrointestinal tract and duodenum, gastrointestinal bleeding, allergic reactions, bronchospasm, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), kidney failure, liver failure, dizziness, tachycardia, increased blood pressure. With prolonged use-headache, visual impairment, tinnitus, hypocoagulation, hemorrhagic syndrome (nosebleeds, bleeding gums, purpura, etc. ), kidney damage with papillary necrosis, Reye’s syndrome in children.

Interaction

Increases the effect of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic drugs.

Concomitant use with other nonsteroidal anti-inflammatory drugs, such as methotrexate, increases the risk of side effects.

Reduces the effectiveness of spironolactone, furosemide, antihypertensive drugs, as well as anti-gouty drugs that promote the elimination of uric acid.

Barbiturates, rifampicin, salicylamide, antiepileptic drugs and other stimulators of microsomal oxidation contribute to the formation of toxic metabolites of paracetamol that affect liver function.

Metocpopramide accelerates the absorption of paracetamol.

Under the influence of paracetamol, the elimination time of chloramphenicol increases by 5 times. Repeated use of paracetamol may increase the effect of anticoagulants (dicoumarin derivatives). Caffeine accelerates the absorption of ergotamine.

Concomitant administration of the drug and alcohol-containing liquids increases the risk of toxic liver damage.

How to take, course of administration and dosage

The drug should not be taken for more than 5 days as an analgesic drug and for more than 3 days as an antipyretic (without the appointment and supervision of a doctor).

Inside (during or after meals),1 tablet every 4 hours, with pain syndrome-1-2 tablets; the average daily dose is 3-4 tablets, the maximum daily dose is 8 tablets.

The course of treatment is no more than 3-5 days.

Overdose

Do not exceed the recommended dose and duration of use!

Symptoms:

– with mild intoxication: nausea, vomiting, stomach pain, dizziness, ringing in the ears;

– with severe intoxication: lethargy, drowsiness, collapse, convulsions, difficulty breathing, anuria, bleeding.

Treatment: gastric lavage using activated charcoal, symptomatic therapy, depending on the state of metabolism – the introduction of sodium bicarbonate, sodium citrate or sodium lactate, which increases the excretion of acetylsalicylic acid due to alkalinization of urine.

Special instructions

Do not prescribe the drug to children under 15 years of age due to the high risk of Reye’s syndrome. Reye’s syndrome is manifested by prolonged vomiting, acute encephalopathy, and enlarged liver.

Acetylsalicylic acid slows down blood clotting. If the patient is going to undergo surgery, you should inform the doctor in advance about taking the drug.

In patients with a predisposition to the accumulation of uric acid, taking the drug can provoke an attack of gout.

During the reception, you should refrain from drinking alcohol (increased risk of gastrointestinal bleeding and toxic liver damage).

Acetylsalicylic acid, when used in the first trimester of pregnancy, has a teratogenic effect; in the third trimester, it leads to inhibition of labor. It is excreted in breast milk, so use during lactation is contraindicated.

Form of production

Pills.

Storage conditions

Keep out of reach of children in the original packaging at a temperature not exceeding 25 °C.

Shelf

life is 3 years.

Active ingredients

: Acetylsalicylic acid, Caffeine, Paracetamol

Dosage form

Tablets

Description

Pregnant women only in the second trimester as prescribed by a doctor, For adults, Children over 15 years of age

Indications

Osteoarthritis, Flu, Cold, Migraine, Arthritis, Neuritis, Lumbago

Weight

Weight: 20 g.